Psychometric liability to psychosis and childhood adversities are associated with shorter telomere length: A study on schizophrenia patients, unaffected siblings, and non-clinical controls.

Compared to the general population, individuals diagnosed with Schizophrenia (SCZ) experience a higher frequency and an earlier onset of chronic medical disorders, resulting in a reduction in life expectancy by an average of 15-25 years. Recently, it has been hypothesized that SCZ is a syndrome of accelerated aging. Childhood adversity was also associated with the pathogenesis and course of SCZ. Our hypothesis was that both SCZ patients and their unaffected siblings would have shorter telomere length (TL) compared to of non-clinical controls. Our additional goals were to determine (1) whether shorter TL correlates with intermediate phenotypes of SCZ (i.e. Psychosis-like symptoms and schizotypal traits); and (2) whether childhood adversities have a moderating role in TL shortening among SCZ and their unaffected siblings. To this end, SCZ patients (n = 100), their unaffected siblings (n = 100) and non-clinical controls (n = 100) were enrolled. The main variables were TL, measured by aTL-qPCR; psychotic-like and schizotypal symptoms, assessed by The Community Assessment of Psychic Experience (CAPE) and the Structured Interview for Schizotypy-Revised (SIS-R), respectively; and childhood adversities evaluated by the Childhood Experience of Care and Abuse (CECA)-Interview. Potentially relevant variables also included in the analyses were: Global Assessment of Functioning (GAF) scores, cognitive performance, and socio-demographic features. In contrast to our hypothesis patients had similar TL when compared to the non-clinical controls. Interestingly, unaffected siblings had longer TL compared to both patients and controls (p < 0.001). Independent from group status a negative correlation was observed between TL and psychotic-like symptoms as rated by the CAPE (p < 0.01). Childhood adversities, especially loneliness between ages 0 and 11 were also negatively associated with TL (p < 0.05). Our findings suggest that psychometric liability to psychosis and childhood adversities may be associated with shorter TL. Unaffected siblings had longer TL, suggesting the potential role of resilience on both the TL and the clinical presentation. These findings must be considered preliminary, calling for larger-scale replication efforts.

Cognitive Features of High-functioning Adults with Autism and Schizophrenia Spectrum Disorders.

OBJECTIVE: Autism Spectrum Disorder (ASD) and schizophrenia share common features in terms of pathophysiology and clinical appearance. Cognitive deficits are also present in both disorders. However, ASD and schizophrenia are heterogeneous syndromes, and  few  studies  have addressed patients with these disorders who have above average educational attainment. In this study, we assessed the cognitive functions of a group of adult ASD patients with adequate mental development and verbal communication skills (High Functioning Autism, HFA) and compared them with a group of Schizophrenia patients matched for level of education. METHOD: Three groups of patients and controls [(HFA, n= 32), Schizophrenia (n= 17), Controls (n= 23)], all with at least a high school education, were assessed with the Wechsler Adult Intelligence Scale (WAIS), Wisconsin Card Sorting Test (WCST), and Rey Auditory Verbal Learning Test (RAVLT). For the assessment of HFA, scores on the Autism Spectrum Disorders in Adults Screening Questionnaire were taken into consideration. Clinical diagnoses were based on DSM-IV TR and DSM-5 criteria. RESULTS: High Functioning Autism and Schizophrenia groups performed similarly in all subtests except for WAIS Comprehension and Digit Symbol, WCST Perseveration, and RAVLT Learning. CONCLUSION: Comprehension abilities of educated adults with HFA could be higher than average in situations that do not involve social interaction. Tendency to perseveration in the presence of adequate concept formation ability may reflect the clinical symptoms of rigidity and repetitive behavior. In patients with higher levels of functioning and education, their diagnosis appears to be weakly associated with cognitive functioning. The potential roles of other variables, such as environmental factors, during development deserve further exploration in future studies.

Exploring the Role of Social Anhedonia in the Positive and Negative Dimensions of Schizotypy in a Non-Clinical Sample.

INTRODUCTION: The present study aimed to investigate the role of social anhedonia, defined as the lack of ability to feel pleasure from interpersonal relationship, in a multidimensional model of schizotypy and to determine the psychometric properties of the Turkish version of Chapman's Revised Social Anhedonia Scale (SAS) in a non-clinical sample. METHODS: Second-grade students of Ankara University Medical Faculty were recruited (n=266, Mage=20.28). Confirmatory factor analysis was performed to test schizotypy dimensions. The Cronbach's alpha internal consistency value, test-retest reliability and congruent validity of SAS were calculated. RESULTS: The model in which social anhedonia was allowed to load on both schizotypy dimensions fit the data set better than the model in which social anhedonia was allowed to load on negative dimension alone. The internal consistency assessed with Cronbach's alpha was .84, test-retest reliability was r=.76 and the congruent validity of SAS was r=.55. CONCLUSION: The results of current study were consistent with those of earlier studies showing that social anhedonia was related to both schizotypy dimensions. Furthermore, the psychometric properties of the Turkish Version of SAS revealed that it is a reliable and valid measurement to assess social anhedonia in a non-clinical population.

[Differential Diagnosis of Schizophrenia: Psychotic Symptoms in Neurodevelopmental Disorders and Psychotic Disorders due to other Medical Conditions]. / Sizofreni Ayirici Tanisi: Baska Bir Tibbi Duruma Bagli Psikotik Bozukluk ve Nörogelisimsel Bozukluklardaki Psikoz Belirtileri.

This review focuses on the differentiation of schizophrenia in the setting of adult psychiatry from neurodevelopmental disorders (NDD's) and psychosis due to other medical conditions (PDMC). Psychotic disorders in early adulthood are most frequently diagnosed with the schizophrenia spectrum or mood disorders. However, they may be the manifestation of neurologic, endocrine or immunologic disease. Individuals with NDD's such as the autism spectrum disorder (ASD) or intellectual developmental disorder (IDD) may also present initially in adulthood. Therefore it is not uncommon that the psychiatrist is the first physician to assess a psychotic patient with underlying medical illness or a NDD. Failure to identify the underlying cause will delay appropriate management. Overdiagnosis of primary psychiatric disorders may be misleading in planning the treatment, as evidence-based treatment algorithms relevant to psychosis are intended for primary psychotic disorders like schizophrenia, and symptomatic treatment may result in unnecessary exposure to antipsychotic drugs. Exclusion of other medical conditions and NDD's is essential before establishing a diagnosis of schizophrenia.

Hemispatial neglect evaluated by visual line bisection task in schizophrenic patients and their unaffected siblings.

Visuospatial attentional asymmetry has been investigated by the line bisection task in patients with schizophrenia, however, those studies are in small number and the results are controversial. The present study aimed to investigate hemispatial neglect in patients with schizophrenia (n=30), their healthy siblings (n=30) and healthy individuals (n=24) by a computerized version of the line bisection task. Deviation from the midline for both hemispaces (mean bisection error-MBE) were calculated and the effects of both hand and line length were controlled. Repeated measures ANOVA yielded a significant hemispace effect for the MBE scores, but no group or group×hemispace interaction effect, i.e., all three groups were inclined to a leftward bias in the left and a rightward bias in the right hemispace. MBEs were significantly different from "zero" only for the right hemispace in siblings and for the left hemispace in controls. Negative symptoms were significantly correlated with the bisection errors in the right hemispace. The results of the present study do not support aberrant hemispheric asymmetry, but bigger bisection errors in schizophrenia.

Social anxiety in patients with Parkinson's disease.

Previous research highlights the presence of social anxiety disorder related to disfiguring diseases, although DSM-IV precludes the diagnosis of social anxiety disorder related to a medical condition. The present study investigated the frequency and severity of social anxiety disorder in patients with Parkinson's disease (n=50) and comparison subjects (n=50). Social anxiety was diagnosed in 16% of patients with Parkinson's disease and 2% of the comparison subjects. Regression analysis revealed younger age and depression as predictive factors of social anxiety. This study supported the likelihood of social anxiety disorder as a comorbid condition in Parkinson's disease. Revision of the criteria for social anxiety disorder in future diagnostic systems is necessary for the detection and management of these patients.

Secondary social anxiety in hyperkinesias.

This is a comparison study that is aimed to investigate and compare the frequency and severity of secondary social anxiety disorder (SAD) in patients with hyperkinesias, which is associated with a significant sense of disfigurement and compromised social interaction. Patients with hemifacial spasm (n = 20), cervical dystonia (n = 20), and essential tremor (n = 20) were evaluated by SCID-I, Liebowitz Social Anxiety Scale, Hamilton Anxiety and Depression Rating Scales, and Sheehan Disability Scale. The DSM-IV H criterion excluding social anxiety related to a medical condition was disregarded for the diagnosis of secondary SAD. The control group (n = 60) consisted of matched healthy subjects. The frequency of the diagnosis and severity of symptoms were compared and associations with sociodemographic and clinical factors were explored. There was no difference between three patient groups in terms of the frequency or the severity of secondary SAD. Younger age and depressive symptoms were associated with the severity of secondary SAD, while severity or duration of the movement disorder or social disability was not. This study revealed a high frequency of secondary SAD in hyperkinesias, emphasizing the need for psychiatric assessment, especially for younger and depressed patients, who seem to be at greater risk.